Capturing Teachable Moments

How one university uses network video to train next-generation speech and language pathologists

By John Bartolac

May 01, 2015

When you’re conducting a therapy session, it’s virtually impossible
to be fully engaged with the client and be an objective
observer of your own interactions at the same time. Yet
both modes are essential to honing a student’s clinical skills.
That’s why the professors in the Department of Communication
Sciences & Disorders at the University of Wisconsin River Falls campus
began taping therapy sessions to provide students with immediate, constructive
feedback on their performance.

Sarah Smits, associate clinical professor in the Department of Communication
Sciences & Disorders, gave an example of how the process works. There was a case
where a speech and language pathology graduate student was given the assignment
to evaluate a young child with delayed speech development. The network video
camera in the therapy room allowed Smits to monitor the session from her office
computer. As Smits watched the session unfold she noticed that the child’s mother,
who was also in the room, was becoming increasingly upset about the task the
student clinician was giving the child to do. The student, being so focused on the
child, was completely unaware of the mother’s agitation.

“Immediately after the evaluation I brought the student into my office, cued up
the recording of the session, and showed her what I had seen,” Smits said. “The
mother’s facial expression said it all. The student instantly understood that she
should have spent time at the beginning of the session putting the mother at ease
by explaining the testing process and involving her in the task. It was a teachable
moment that we might never have had with our old analog system because the
VHS tapes were so inconvenient to deal with.”

Making a Good Idea Better

The Community Speech, Language and Hearing
Clinic run by the Department of Communication
Sciences & Disorders provides an important training
ground for undergraduate and graduate students in its
speech pathology program. Graduate students work
with real clients who come to the practical learning
lab with a host of speech and language disorders—
from stuttering and aphasia to Asperger’s syndrome.

Supervising professors watch each student-led
therapy session either from an observation room with
one-way glass or remotely over the network from their
office elsewhere in the building. In addition, video
cameras in the therapy rooms stream the sessions over
the network so that they can be viewed remotely in
real time on more than one professor’s desktop and
simultaneously archived for later review and evaluation
of students’ clinical skills.

When the department introduced analog VCRbased
cameras into the clinical curriculum years ago,
it was considered quite an advanced teaching tool. But
because it was so cumbersome to operate, it wasn’t
being used to its fullest potential. As it aged, breakdowns
become more frequent. And because the system
was too complex for instructors to troubleshoot
themselves, the equipment would be out of commission
for days until a service call could be scheduled.

Even when the system was operational, “recording
and reviewing stacks of VHS tapes, finding the exact
sessions you wanted to use, queuing them up, and
then taking them up to the classroom to show was
pretty time consuming,” said Smits. “And even after
all that effort you just crossed your fingers that the
tapes worked on the classroom VCR.” Consequently,
many teaching opportunities were lost.

So, when the system reached its end of life, the
department looked for a replacement that was more
user-friendly and would provide higher quality audio
and video recordings of student-led therapy sessions.
They felt that adopting a network video model would make it much easier for students and faculty
to review and analyze the sessions on demand. It
would also allow faculty to remotely observe students
live during client sessions.

Revamping the Clinic Therapy Rooms

The department chose a turnkey solution from PDS,
Inc. similar to the system installed in its sister campus
in Eau Claire. CompView, an audio-visual systems
integrator, installed the intuitive intelligent stream recorder (ISR) software and HDTVquality
fixed and PTZ network cameras
from Axis Communications to capture
therapy sessions at the clinic and
stream recordings to the ISR server in
the campus data center.

CompView replaced the old standard-
definition analog cameras in
the four pediatric therapy rooms with
HDTV-quality PTZ dome network
cameras with two-way audio capability.
The cameras were mounted on vertical
bars so that clinicians could manually
move them up and down from 18 to 48
inches from the floor.

“This was critical for capturing
close-ups of children’s faces and their
verbalizations whether they were sitting
in a chair or playing on the floor with
the therapist,” Smits said.

Because adults tend to move around
less than children during therapy, the
department chose three-megapixel Axis
network cameras with two-way audio
for the adult therapy rooms. Smits said
the department is considering swapping
out one or two of those cameras
for Axis PTZ models at some point for
more observational flexibility.

Given that students and supervisors
would be listening closely to affected
speech, Smits chose both camera
models because their visual clarity was
matched by equally exceptional audio
quality. The two-way audio allows supervisors
to monitor therapy sessions
remotely and jump in with a vocal comment
as needed.

“It’s amazing how much simpler
the network camera system is,” said
Erin Shannon, system designer for
CompView. “The old analog system
needed two full racks of audio/video
gear plus countless feet of cabling to
support it. And then each TV monitor
needed its own associated VCR. The
new IP-based system plugs directly
into the building’s existing network
with a network switch and streams the
video to the main server several buildings
away.

“Professors just log onto the network
from their desktops to turn on
the cameras, control the PTZ features,
adjust volume levels and retrieve stored
video,” Shannon said. “Groups of students
can sit in front of large screen
high-definition monitors in the computer
lab and watch live sessions or pull
up recorded sessions from the archives
as part of their coursework.”

The Intelligent Stream Recorder
software lets clinical students use free
text or drop-down menus to classify the
type of session being recorded, such as
a client with a hearing loss, a stutter or
a lisp. Because the video is catalogued
using searchable descriptive tags, it
also makes it fast and easy for a professor
teaching a class about a particular
speech or language disorder to search
the database for therapy sessions that
illustrate that specific disorder or intervention
technique.

Making Teachable Moments
More Sharable

“Since network video can be cued up with
a simple click of the mouse, professors
are now incorporating clips in their weekly
classes on a regular basis,” Smits said.
“They couldn’t have hoped to match that
frequency in the past because it was just
too cumbersome and time-consuming to
find the segments they needed.”

Reviewing VCR tapes twice a semester
for student assessments was also
problematic, Smits said, because there
were no standards for labeling the VCR
tapes. With multiple sessions recorded
on a single tape there was no quick way
to queue to the exact spot you wanted
to watch. Since supervisors and instructors
carry an average caseload of 10 student/
client pairs a semester, they spent
an inordinate amount of time searching
for footage, time they would have
rather spent evaluating performance.
All that changed when the new system
was installed. Since video is archived by
descriptive, searchable tags, Smits reports
that “finding” time has been cut
to 15 to 20 minutes per semester.

Students also felt stymied by the old
analog technology. Since it took nearly
30 minutes to program the system to record
a client session, students typically
recorded only two therapy sessions per
client per semester. Now, with less than
five minutes of programming time, students
can set up the new system to automatically
record all their sessions for
an entire semester. With more frequent
opportunities to monitor clinical progress
and receive feedback, supervisors
are able to offer more timely encouragement
and praise for appropriate interactions
and suggest different ways of
cuing and behavioral management to
improve clinical outcomes.

“The new Axis high-definition cameras
give students and supervisors the
audio and video clarity they need to
catch the nuanced interaction between
patients and clinicians,” Smits said. “And
because it is so easy to use, it delivers an
endless supply of teachable moments.”

The department finds the recorded
therapy sessions so valuable that
they’re contemplating sharing them
with receptive parents to teach them
how better interact with their children
when practicing speech and language
skills at home.

This article originally appeared in the May 2015 issue of Security Today.